Comparison of Prophylactic Phenylephrine Infusion and Rescue Bolus Administration for Maintaining Blood Pressure During Spinal Anaesthesia for Caesarean Delivery in Obese Parturient: A Randomised Control Trial.

IF 1.1 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Malaysian Journal of Medical Sciences Pub Date : 2024-06-01 Epub Date: 2024-06-27 DOI:10.21315/mjms2024.31.3.8

Shamsul Kamalrujan Hassan, Pit Cui Wong, Praveena Seevaunnamtum, Sanihah Che Omar, Nik Abdullah Nik Mohamad

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Abstract

Background: Phenylephrine (PE) is one of the vasopressor used to treat hypotension during anaesthesia. The primary aim of this study was to compare the effect of prophylactic infusion and rescue bolus of PE on the haemodynamic changes during spinal anaesthesia (SA) for Caesarean section (CS) in obese parturients.

Methods: A total of 74 obese parturients scheduled for elective CS under SA were randomised into two groups; Group A (n = 37) received prophylactic PE infusion starting at 50 μg min^-1 and adjusted according to the given algorithm and Group B (n = 37) received 100 μg PE bolus to treat hypotension. The measured parameters were systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), the total requirement of PE and neonatal Apgar score.

Results: Six patients were excluded from the analysis due to missing data and only 68 were analysed. Group A showed significantly higher SBP, DBP and MAP than Group B (P < 0.05). The requirement of PE was higher in Group A than Group B [817.7 (265.7) μg versus 360.6 (156.0) μg; P = < 0.05]. Both groups had no difference in terms of the neonatal Apgar score.

Conclusion: Prophylactic PE infusion provided better haemodynamic control than therapeutic boluses in obese parturients undergoing CS under SA.

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在肥胖产妇剖腹产脊麻过程中，比较预防性输注苯肾上腺素和抢救性给药以维持血压：随机对照试验。

背景：苯肾上腺素（PE）是用于治疗麻醉期间低血压的血管抑制剂之一。本研究的主要目的是比较预防性输注和抢救性栓注 PE 对肥胖产妇剖腹产脊髓麻醉（SA）期间血流动力学变化的影响：将 74 名肥胖产妇随机分为两组：A 组（37 人）接受预防性 PE 输注，输注量为 50 μg min-1，并根据给定的算法进行调整；B 组（37 人）接受 100 μg PE 栓剂以治疗低血压。测量参数包括收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、PE总需要量和新生儿Apgar评分：由于数据缺失，6 名患者被排除在分析之外，因此仅对 68 名患者进行了分析。A 组的 SBP、DBP 和 MAP 明显高于 B 组（P < 0.05）。A 组的 PE 需求量高于 B 组 [817.7 (265.7) μg 对 360.6 (156.0) μg；P = < 0.05]。两组的新生儿阿普加评分没有差异：结论：对于在 SA 下进行 CS 的肥胖产妇，预防性 PE 输注比治疗性栓剂能更好地控制血流动力学。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Malaysian Journal of Medical Sciences MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

2.70

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access, fully online journal that is published at least six times a year. The journal’s scope encompasses all aspects of medical sciences including biomedical, allied health, clinical and social sciences. We accept high quality papers from basic to translational research especially from low & middle income countries, as classified by the United Nations & World Bank (https://datahelpdesk.worldbank.org/knowledgebase/ articles/906519), with the aim that published research will benefit back the bottom billion population from these countries. Manuscripts submitted from developed or high income countries to MJMS must contain data and information that will benefit the socio-health and bio-medical sciences of these low and middle income countries. The MJMS editorial board consists of internationally regarded clinicians and scientists from low and middle income countries.